Provider Demographics
NPI:1962085167
Name:KOSINSKI, JENNIFER LYNN (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:KOSINSKI
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:50920 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-1367
Mailing Address - Country:US
Mailing Address - Phone:586-307-4757
Mailing Address - Fax:855-393-6740
Practice Address - Street 1:50920 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-1367
Practice Address - Country:US
Practice Address - Phone:586-307-4757
Practice Address - Fax:855-393-6740
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101009398235Z00000X
MI7152000889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist